United Healthcare Community Plan Lakeland Care 2019 1

United. Healthcare Community Plan Lakeland Care 2019 1

UHCprovider. com Register at UHCprovider. com/newuser to use Link, your gateway to United. Healthcare’s online tools. Find administrative guides, policies and protocols. https: //www. uhcprovider. com/ Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group. Access the most used transactions and information.

UHCProvider. com: Michigan Homepage All the United. Healthcare Community Plan resources you need in one place: • • • Care Provider Manual. Prior Authorization and Notification Pharmacy Newsletters Forms https: //www. uhcprovider. com/en/health-plans-by-state/michigan-health-plans/mi-comm-plan-home. html Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group.

Link Provider Portal eligibility. Link: Benefits and eligibility information claims. Link: Claim status and payment determination/ remediation Electronic Payments and Statements Document Vault: Contains Patient Care Opportunity Reports (PCOR) & claim letters Paperless Delivery Options: Turn off paper letters Prior Authorization and Notification: Prior authorization determination and submission referral. Link: Referral determination and submission Pre. Check My. Script: Run a pharmacy trial claim and get real-time prescription coverage detail for your patients Access Link here: https: //www. uhcprovider. com/en/resource-library/link-provider-self-service. html Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group.

Link Highlight: Prior Authorization & Notification With the Prior Authorization and Notification tool on Link, you can: • • Determine if prior authorization or notification is required for United. Healthcare Commercial, United. Healthcare Medicare Solutions, and United. Healthcare Community Plan members. Complete your request for notification or prior authorization if it is required and can be completed online. ─ Inpatient or outpatient Upload medical notes or other attachments when required and add messages for the reviewer when attachments are required. Check the status of your notification and prior authorization requests – including those made by phone. For more information, training and Quick Reference Guide, please visit: https: //www. uhcprovider. com/en/prior-auth-advance-notification/prior-auth-app. html To access prior authorization requirements by Plan, please visit: https: //www. uhcprovider. com/en/prior-auth-advance-notification/adv-notification-plan-reqs. html Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group. 5

Link Highlight: Pre. Check My. Script makes it easy to get real-time, patient-specific prescription drug data at the point of care • Runs a trial claim through United. Healthcare’s system • Integrates seamlessly into your EMR by automatically displaying when you prescribe medication for a United. Healthcare member • Prompts you with prior authorization requirements, coverage details, possible medication alternatives, out-of-pocket costs (when applicable), and more • Allows you to submit electronic prior authorizations – often receiving immediate approval • View member information, including previous prior authorization requests • Available on these EMRs: athenahealth, Dr. First, New. Crop and NEW! Allscripts For more information, please visit: https: //www. uhcprovider. com/en/resource-library/link-provider-self-service/precheck-myscript. html Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group. 6

UHCProvider. com: Network Bulletin Sign up for the Network Bulletin to get news & updates regarding policy, product, or reimbursement changes. Delivered directly to your email inbox every month! • United. Healthcare Commercial • United. Healthcare Reimbursement Policies • United. Healthcare Community Plan • United. Healthcare Medicare Advantage • United. Healthcare Affiliates • State News. https: //www. uhcprovider. com/ Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group.

Medicaid & Healthy Michigan Plan ID Cards Medicaid Healthy Michigan Plan Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group. 8

DSNP ID Card Medicare Advantage Plan; administered by United. Healthcare Community Plan Assigned Provider Sample ID cards are for illustration only. Actual cards may vary. Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group. Dual Complete Plan Name Group Name: MIDSNP

Dual Complete (DSNP) Expanding to 19 New Michigan Counties 2020 Expansion Counties: • • • Antrim Arenac Benzie Cass Clare Crawford Grand Traverse Kalkaska Lake Leelanau • • • Livingston Manistee Missaukee Ogemaw Osceola Otsego Roscommon Wayne Wexford Existing Service Area Includes: • • • Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group. Allegan Barry Bay Berrien Branch Calhoun Gratiot Hillsdale Kalamazoo Kent • • • Mecosta Montcalm Newaygo Ottawa Saginaw Sanilac St. Joseph Tuscola Van Buren Washtenaw

New Provider Checklist Register for an Optum ID ühttps: //www. uhcprovider. com/en/new-user. html üProvider portal, LINK üSign up to receive the provider newsletter Network Bulletin üApply for Electronic Payments and Statements (EPS) üFree online trainings are available Review reference information üCare Provider Manual üPrior Authorization Requirements üForms Proprietary information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group. 11